Lung RADS: Lessons Learned and Strategies for the Optimization of Lung Cancer Screening

Purpose of Review Lung cancer screening (LCS) using low-dose chest CT (LDCT) has been shown to decrease lung cancer specific morbidity and mortality (Jonas et al. in JAMA 325(10):971–87, 2021•). We aim to discuss important current and evolving concepts related to LCS, including major updates to the US Preventive Services Task Force (USPSTF) recommendations and to the lexicon used by radiologists in the reporting of LCS LDCT, the Lung Imaging Reporting and Data System (Lung-RADS). Recent Findings The number of individuals eligible to receive LCS has increased following the latest update to USPSTF recommendations, notably among women, minorities, and individuals of lower socioeconomic status (Ritzwoller et al. in JAMA Netw Open 4(10):e2128176, 2021). Since the inception of LCS programs, emerging evidence has allowed for updates to the Lung-RADS guidelines aimed at optimizing LCS efficiency and addressing various challenging clinical scenarios. Summary LCS has continually evolved since its debut. Updated guidelines aim at improving outcomes in the at-risk population. Nevertheless, continued efforts focused on increased LCS uptake are needed. Less than 6% of the eligible population is currently enrolled in a LCS program nationwide, while screening programs for breast and colon cancer have participation rates of 60–70% (New Report: Critically Low Lung Cancer Screening Rates Reveal Opportunity to Save More Lives. American Lung Association, 2022; Hall in Prev Chronic Dis 15, 2018).